Health and Wellness

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Providing a Nudge Toward Healing Through Integrative Health

A patient arrives at UW Health’s Integrative Health Clinic with chronic gastrointestinal complaints. Rather than simply prescribe a new medication or different diet, David Kiefer, MD, spends an hour delving into the woman’s medical history, understanding her health goals, and recommending a treatment plan that includes diet changes, probiotics and regular meditation.

“People will report really interesting results: improvement of their GI symptoms, better sleep and a better mood,” says Kiefer, the clinic’s medical director. “I’m not giving patients a magic pill, and patients have to make some changes in their life, but that mixture can bring about some fantastic improvements.”

In addition to addressing chronic problems, integrative medicine consultations can also focus on prevention. “A classic example might be a middle-aged patient who is starting to develop health troubles but nothing that requires major intervention,” he says. “They may be worried about a family history of heart disease or osteoporosis, and we can talk about supplements that might be helpful for prevention or work on a really holistic health strategy.”

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Kiefer’s patients come from all walks of life, from young co-op shopping Madisonians to rural truck drivers, all seeking a fresh perspective on problems ranging from chronic back pain to allergies to chemotherapy side effects.

“We essentially provide a second opinion,” he says. “With integrative health, we might have a few extra tools in our toolbox, and we have the extra time to sit with a patient. It’s about adding some options that patients might benefit from.”

Integrative health consultations with physicians are often covered by insurance.

What to Expect From an Integrative Health Consultation

Here’s what to expect from your first visit:

More time with the doctor. The initial consultation takes approximately 60 minutes — significantly longer than a traditional clinic visit. “It feels like a luxury and patients love it, but sometimes it feels like we’re just getting started,” Kiefer says. “An hour goes by pretty quickly.”

A personalized plan. “All of this is so individualized that one back pain patient won’t be the same as another back pain patient,” he says. “That’s why this is compelling to a lot of patients because people want an individualized approach to their treatment.”

The “Whole Me” approach. This model puts the patient at the center of a healing circle that encompasses eight aspects of self-care, including sleep, nutrition, activity levels and spirituality. “During the visit, we like to touch on all those different aspects of health, and we talk about areas people want to work on or strengths we can tap into,” Kiefer explains. “Using a patient-directed approach, we look at what they could nudge or use help on.”

Envision your goals. Change the focus from managing your diabetes or hypertension to why you want to improve your health. Is it so you can keep up beloved hobbies or play with your grandkids well into retirement? “That kind of social goal shifts the focus from number chasing and dosing, and that’s enough to provide a new perspective on your health,” Kiefer says. “The ‘Whole Me’ approach focuses on the big picture and your health goals, and everyone should do that kind of introspection on a regular basis.”

Commit to change. “The more motivation people bring to their healing encounter, the better,” Kiefer notes. “It’s not always easy to change something like diet, or to start a meditation practice or do 10 to 20 minutes of daily exercise when you have two jobs and a busy life. These are changes that can make a huge difference, but they won’t work if we can’t help you to successfully do them.”

Diet changes are often key. “There’s a huge body of knowledge about the anti-inflammatory effect not only what we eat, but how we live our lives,” he says. “This idea that food is medicine: We may not necessary make a direct connection between what we eat and how we feel, but the food connection with some disease states is new and exciting to look at.”

Learn what not to do. Sometimes the advice might be to stop something, like when a health-conscious patient admits to taking 15 to 20 vitamins or herbal supplements. “Once you get above 5 to 8 supplements or pharmaceuticals, you start to have a pretty high chance of interactions,” Kiefer explains. “People take incorrect supplement doses or overlapping products that provide the same vitamin, for instance. We spend a lot of time talking about quality products and quality providers who’ve had the right training. Anything we recommend is something we’ve vetted.”

Evidence-based treatments. An integrative health physician probably won’t recommend strategies that aren’t backed up by research, and they may know of strategies that other doctors are less familiar with. Kiefer strives to stay up on the latest research on everything from the microbiome to the health impact of regular meditation, and he tries to share this information with patients and providers alike. “There’s a lot of evidence that supports the suggestions that come out of integrative health. Other providers may know about integrative treatments but don’t have the time to look into them in depth. That’s where we come in,” he says.

Follow up. A second visit a month or two after the first is helpful to check in on goals, “and then a lot of patients like to have a 6-month ‘tune-up’ of sorts,” Kiefer says.

Continue to see your other providers. “We don’t want to take the place of the care a patient is receiving from primary care providers or other specialists,” Kiefer notes. “You can’t beat that 20-year relationship between the provider and the patient ... we can’t do that in a consult clinic. But with integrative health, we can bring a new perspective and plant a seed that might grow.”

For Kiefer, the results are often gratifying. He recalls one “tough as nails” farmer who came in with chronic aches and pains. With the help of diet changes and relaxation techniques, he started feeling better. “Just to know that this approach can meet the needs of a variety of patients with a range of health goals is deeply satisfying,” Kiefer says.